The Impact of COVID-19 on Cholesteatoma Diagnosis and Treatment

This investigation aimed to examine the effects of the COVID-19 pandemic on treatment delays and the severity of initial disease presentation in cholesteatoma patients treated in the prepandemic and pandemic periods.

This retrospective cohort study was of patients who underwent primary surgical management of cholesteatoma between October 2018 and December 2021, split between the prepandemic (October 2018 to February 2020) and pandemic (April 2020 to December 2021) time periods. Data collected included time from referral to otology clinic visit, time of diagnosis, and time of surgical interventions. The extent of cholesteatoma disease and surgery, hearing loss levels, and the need for additional surgical intervention were also considered. The datasets were compared using the Wilcoxon rank-sum test.

Eighty-six patients met inclusion criteria, 36 of whom were treated prepandemic and 50 after March 2020. Of the examined variables, only time from diagnosis to surgery and case duration were significantly different between the two cohorts, with the pandemic cohort experiencing less time between initial diagnosis and surgery (51.4 days prepandemic vs. 38.4 days pandemic, p = 0.02) and shorter case duration (221.0 minutes prepandemic vs. 171.8 minutes pandemic, p = 0.0008). There was no difference between the severity of presentation in the prepandemic and pandemic populations.

There was no significant difference in disease severity or delays in treatment when comparing the prepandemic to the pandemic population. There was a quicker time from referral to surgery and decreased surgical times during the pandemic.